Evaluation of vascular patterns of cervical lymph nodes with power Doppler sonography

Giovagnorio, F; Caiazzo, Rossella; Avitto, A

doi:10.1002/(sici)1097-0096(199702)25:2<71::aid-jcu4>3.0.co;2-g

Cited by 65 publications

(43 citation statements)

References 13 publications

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“…[8][9][10][11][12] However, an understanding of the vasculature of normal nodes is necessary as a reference for differential diagnosis. This information is lacking in literature.…”

Section: Discussionmentioning

confidence: 99%

Power Doppler sonography of normal cervical lymph nodes.

Ying

Ahuja

Brook

et al. 2000

Journal of Ultrasound in Medicine

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This study was undertaken to investigate the vascular patterns and resistance of normal cervical nodes by power Doppler sonography. In 101 subjects who had a sonographic examination of the neck, 1050 lymph nodes were detected. Only central vascularity was found in normal cervical nodes. The degree of vascularity in submental and submandibular nodes was higher than that in other regional nodes. Submental nodes had a higher vascular resistance in association with a lower blood flow velocity than other regional nodes. No significant difference was found in blood flow velocities and vascular resistance between male and female subjects. The vascular resistance increased significantly with age. This study provides a baseline for vascularity within normal cervical nodes, as seen by power Doppler sonography.

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“…[8][9][10][11][12] However, an understanding of the vasculature of normal nodes is necessary as a reference for differential diagnosis. This information is lacking in literature.…”

Section: Discussionmentioning

confidence: 99%

Power Doppler sonography of normal cervical lymph nodes.

Ying

Ahuja

Brook

et al. 2000

Journal of Ultrasound in Medicine

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“…16 The occurrence of vascularity in normal nodes increases with increasing size, and about 90% of normal nodes with maximum transverse diameters greater than 5 mm show hilar vascularity. 17 Reactive nodes tend to have prominent hilar vascularity 15,18 because of an increase in vessel diameter and blood flow. 14 In malignant nodes, 4 predominant abnormal vascular patterns have been described: avascular areas, displacement of vessels, increased peripheral vessels, and an aberrant course of hilar vessels.…”

Section: 1011mentioning

confidence: 99%

Lymph node hilus: gray scale and power Doppler sonography of cervical nodes.

Ahuja

Ying

King

et al. 2001

J of Ultrasound Medicine

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Objective. To investigate the difference in the nodal hilus evaluated by gray scale and power Doppler sonography. Methods. One hundred ninety-two patients with proven cervical lymphadenopathy were included in the study (metastases, n = 118; tuberculosis, n = 56; and lymphoma, n = 18). Lymph nodes were evaluated by gray scale sonography for the echogenic hilus and power Doppler sonography for hilar vascularity. Results. Hilar vascularity was found even though the lymph node did not show an echogenic hilus on gray scale sonography (metastases, 59%; tuberculosis, 66%; and lymphoma, 91%). Conclusions. Sonologists should be aware that gray scale and Doppler sonography show different aspects of the hilus, and the absence of the hilus on gray scale sonography does not necessarily imply an associated absence of hilar vascularity. Key words: gray scale sonography; power Doppler sonography; hilus; cervical nodes. he role of sonography in the evaluation of neck nodes is well established. Previously, sonography of lymph nodes involved only gray scale sonography, and evaluation of the nodal hilar architecture was an essential part of the examination. The absence of a hilus was usually considered an abnormality.1,2 However, to our knowledge, the sonographic literature has not addressed whether the absence of an echogenic hilus on gray scale sonography implies the absence of hilar vasculature. With power Doppler sonography (PDS), it is now possible to evaluate intranodal vasculature.In our experience, often in abnormal nodes the echogenic hilar architecture is absent on gray scale imaging (Fig. 1), but the hilar vessels are clearly shown on PDS (Fig. 2). Because this has not been emphasized in the literature, often sonologists have presumed that the absence of the echogenic hilus on gray scale sonography also implies the absence of hilar vasculature. We were therefore interested in documenting the appearance of hilar vessels so that sonologists would be aware of the differences in nodal hilar evaluation by gray scale sonography and PDS.

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“…An earlier power Doppler study done by Giovagnorio and colleagues classified the vascular patterns of cervical lymph nodes into three types (single or hypertrophic hilar pole, peripheral vascularity). 18 Their classification was useful in the detection of chronic inflammation but less accurate in the differentiation of acute inflammation and metastatic lesions. 3D power Doppler sonographic interrogation in our study revealed that their classification would be more comprehensive if patterns of irregular hypertrophic pole and spotted vascularity were considered.…”

Section: -Test)mentioning

confidence: 99%

Two-dimensional and three-dimensional power Doppler sonographic classification of vascular patterns in cervical lymphadenopathies.

Shih²,

Chang³

et al. 1998

Journal of Ultrasound in Medicine

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Vascular patterns may reflect some pathologic behaviors of tumors and lymph nodes. Power Doppler ultrasonography, with improved sensitivity and better noise contrast, were used to depict vasculature in 289 cases of cervical lymphadenopathy. Four patterns of vasculature, in addition to avascular nodes, were classified. Benign lymphadenopathies represented 89% and 83% of avascular and hilar type nodes, respectively. However, malignant lymphadenopathies dominated in nodes that were of spotted (72%), peripheral (60%), and mixed type (80%). Correlation between nodal sizes and chronologic changes of vascular patterns in malignant lymphadenopathies implied a reasonable classification. Three‐dimensional power angiography, with the advantage of less plane‐sampling bias, was further used to validate our classification.

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Evaluation of vascular patterns of cervical lymph nodes with power Doppler sonography

Cited by 65 publications

References 13 publications

Power Doppler sonography of normal cervical lymph nodes.

Power Doppler sonography of normal cervical lymph nodes.

Lymph node hilus: gray scale and power Doppler sonography of cervical nodes.

Two-dimensional and three-dimensional power Doppler sonographic classification of vascular patterns in cervical lymphadenopathies.

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